Bill Text: MS HB424 | 2026 | Regular Session | Engrossed

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Bill Title: Mental health; authorize assisted outpatient treatment (AOT) as alternative to impatient commitment for certain persons.

Sponsorship: Bipartisan Bill

Status: (Failed) 2026-03-03 - Died In Committee [HB424 Detail]

Download: Mississippi-2026-HB424-Engrossed.html

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MISSISSIPPI LEGISLATURE

2026 Regular Session

To: Public Health and Human Services; Judiciary A

By: Representative Creekmore IV

House Bill 424

(As Passed the House)

AN ACT TO AMEND SECTION 41-21-74, MISSISSIPPI CODE OF 1972, TO AUTHORIZE ASSISTED OUTPATIENT TREATMENT (AOT) AS AN ALTERNATIVE TO INPATIENT COMMITMENT FOR PERSONS WHO MEET CERTAIN CRITERIA; TO SPECIFY WHO MAY INITIATE AN AOT ORDER; TO REQUIRE THE COURT TO MAKE CERTAIN FINDINGS BEFORE ENTERING AN AOT ORDER; TO REQUIRE THE SUBMISSION AND UPDATING OF A TREATMENT PLAN AFTER ENTRY OF AN AOT ORDER; TO PROVIDE THAT THE RESPONDENT SHALL HAVE THE RIGHT TO AN ATTORNEY AT ALL STAGES OF ANY PROCEEDING INVOLVING AOT; TO SPECIFY THE INITIAL LENGTH OF AN AOT ORDER AND AUTHORIZE RENEWALS OF THE ORDER; TO AUTHORIZE CERTAIN PERSONS TO FILE AN AFFIDAVIT OF NONCOMPLIANCE WITH A TREATMENT PLAN; TO REQUIRE SCREENING BEFORE SUCH AN AFFIDAVIT IS FILED; TO PROVIDE THAT THE COUNTY OF RESIDENCE SHALL BE RESPONSIBLE FOR COMMUNITY COORDINATION, TRANSPORTATION, AND FOLLOW-UP SERVICES; TO REQUIRE LOCAL SCREENING BEFORE RETURNING THE RESPONDENT TO A STATE HOSPITAL FOR NONCOMPLIANCE; TO PROVIDE THAT THE CHANCERY COURT OF THE COUNTY WHERE THE PUBLIC FACILITY IS LOCATED OR THE COMMITTING COURT SHALL HAVE JURISDICTION OVER MATTERS RELATING TO AOT ORDERS; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  Section 41-21-74, Mississippi Code of 1972, is amended as follows:

     41-21-74.  * * *(1)  If the commitment order directs outpatient treatment, the outpatient treatment physician may prescribe or administer to the respondent treatment consistent with accepted medical standards.

(2)  If the respondent fails or clearly refuses to comply with outpatient treatment, the director of the treatment facility, his designee or an interested person shall make all reasonable efforts to solicit the respondent's compliance.  These efforts shall be documented and, if the respondent fails or clearly refuses to comply with outpatient treatment after such efforts are made, such efforts shall be documented with the court by affidavit.  Upon the filing of the affidavit, the sheriff of the proper county is authorized to take the respondent into his custody.

(3)  The respondent may be returned to the treatment facility as soon thereafter as facilities are available.  The respondent may request a hearing within ten (10) days of his return to the treatment facility.  Such hearing shall be held pursuant to the requirements set forth in Section 41‑21‑81. 

(4)  The chancery court of the county where the public facility is located or the committing court shall have jurisdiction over matters concerning outpatient commitments when such an order is sought subsequent to an inpatient course of treatment pursuant to Sections 41‑21‑61 through 41‑21‑107, 43‑21‑611, 99‑13‑7 and 99‑13‑9.  An outpatient shall not have or be charged for a recommitment process within a period of twelve (12) months of the initial outpatient order. (1)  Use of commitment procedures.  The procedures set forth in Sections 41-21-61 through 41-21-107 may be used to order assisted outpatient treatment (AOT), formerly referred to as outpatient commitment (OPC), for individuals who meet the criteria in this section.

     (2)  Definition of AOT.  As used in this section, "assisted outpatient treatment" means a court-ordered plan of community-based behavioral health treatment for an individual with a serious mental illness or co-occurring disorder who is unlikely to maintain stability without structured support.  AOT shall provide a structured, court-supervised alternative to inpatient hospitalization and shall be administered in the least restrictive environment consistent with clinical needs and public safety.

     (3)  Eligibility for AOT.  An individual is eligible for AOT when:

          (a)  The individual has a serious mental illness or co-occurring disorder;

          (b)  Nonadherence to treatment has previously resulted in at least one (1) of the following:

              (i)  Rehospitalization;

              (ii)  Criminal justice involvement; or

              (iii)  Demonstrated risk of harm to self or others;

          (c)  The individual is unlikely to remain stable without supervised outpatient treatment; and

          (d)  The individual is likely to benefit from AOT.

     (4)  Initiation of an AOT order.  An AOT order may be initiated by any of the following:

          (a)  A state hospital;

          (b)  A crisis stabilization unit for individuals at high risk of recidivism; or

          (c)  A chancery judge or special master as an alternative to civil commitment.

     (5)  Required judicial findings.  Before entering an AOT order, the chancery or circuit court shall make written findings, based upon clear and convincing evidence, that the respondent:

          (a)  Has a serious mental illness or co-occurring disorder;

          (b)  Is unlikely to remain stable in the community without supervision based upon a pattern of treatment nonadherence resulting in hospitalization, arrest or dangerousness within the preceding thirty-six (36) months;

          (c)  Is capable of living safely in the community with a court-ordered treatment plan; and

          (d)  Is likely to benefit from structured outpatient treatment and requires such treatment to prevent relapse likely to result in serious harm to self or others.

     (6)  Submission and updating of treatment plan.  (a)  Within ten (10) days of the entry of an AOT order, the community mental health center or treating mental health professional shall submit to the court an update on the respondent's compliance with the AOT, which shall be incorporated into the order.  This update shall state in detail whether or not the respondent is in compliance.

          (b)  The same update on compliance shall be resubmitted at least every ninety (90) days to the court.

     (7)  Authority to provide treatment under AOT.  (a)  If the commitment order directs outpatient treatment, the outpatient treatment physician or treating provider may prescribe or administer to the respondent treatment consistent with accepted medical standards and within the scope of the AOT order.

          (b)  The order shall incorporate or reference the individualized treatment plan developed by the community mental health center or other aftercare provider and the discharge plan from a state hospital, and approved by the court.

     (8)  Appointment of attorney.  (a)  The respondent shall have the right to be represented by an attorney at all stages of any proceeding involving AOT, including, but not limited to:

              (i)  Entry of an AOT order;

              (ii)  Modification, extension, or termination of an AOT order; and

              (iii)  Proceedings to return the respondent to inpatient care.

          (b)  If the respondent is indigent, unwilling, or unable to retain counsel, the court shall immediately appoint an attorney to represent the respondent as under Sections 41-21-67 and 41-21-83.

          (c)  Any waiver of rights under Section 41-21-76 shall be made only after consultation with counsel and shall be placed on the record.

     (9)  Length of order.  An initial AOT order shall not exceed one hundred eighty (180) days.

     (10)  Renewal of order.  The court may thereafter renew the order for additional periods not to exceed one hundred eighty (180) days each, not to exceed twelve (12) months in total, based upon:

          (a)  A current clinical evaluation; and

          (b)  Documentation demonstrating continued benefit or clinical necessity.

     (11)  Definition of noncompliance.  (a)  As used in this section, "noncompliance" means failure to follow material components of the treatment plan after reasonable efforts to re-engage have been attempted and documented.

          (b)  Minor lapses, including missed medications where prompt re-administration is possible, shall not alone constitute noncompliance.

     (12)  Authorized filers of noncompliance affidavits.  An affidavit of noncompliance may only be filed by:

          (a)  The director of the treatment facility, his or her designee or an interested person;

          (b)  A community mental health center mental health professional or other treating mental health professional responsible for the respondent's aftercare; or

          (c)  A district attorney or assistant district attorney only in cases arising out of a circuit court order involving competency or nonrestorability.

     Any affidavit of noncompliance must result in a clinical screening by a mental health professional before any inpatient placement is ordered.

     (13)  Required screening.  (a)  Before such affidavit of noncompliance is filed, a community mental health center mental health professional shall conduct and document a pre-affidavit screening to determine:

              (i)  Whether the individual meets criteria for civil commitment; and

              (ii)  Whether the concerns can be addressed at a lower level of care.

          (b)  Documentation shall include:

              (i)  The specific ways the individual has failed to comply; and

              (ii)  The reasonable efforts made to assist the individual in complying, including offering the opportunity to receive missed medication.

          (c)  An isolated failure, such as a single missed medication dose, shall not support return to a state hospital without opportunity to remediate.

     (14)  Resumption after hospitalization.  If an individual under an AOT order is hospitalized, the order shall pause and automatically resume upon discharge unless modified by the court.

     (15)  County of responsibility.  The county of residence shall be responsible for community coordination, transportation, and follow-up services unless the court orders otherwise.

     (16)  Substance use disorder treatment.  AOT may be ordered for individuals with substance use disorders when a qualified nonhospital provider is designated to deliver treatment.

     (17)  Requirement of local screening before return to hospital.  (a)  Upon filing of a properly documented affidavit of noncompliance, the sheriff may take custody of the respondent.

          (b)  Before return to a state hospital, the respondent shall first be transported, when practicable, to:

              (i)  A community mental health center; or

              (ii)  A Department of Mental Health-certified crisis stabilization unit for screening, triage and stabilization.

          (c)  Return to a state hospital may occur only if screening determines civil commitment criteria are met and no lesser restrictive level is sufficient.

          (d)  Screening results shall be made part of the record.

     (18)  Jurisdiction.  The chancery court of the county where the public facility is located or the committing court shall have jurisdiction over matters relating to AOT orders.

     (19)  Terminology.  Wherever the term "outpatient commitment" appears in a statute, rule, order or document, it shall be construed to mean "assisted outpatient treatment (AOT)."

     SECTION 2.  This act shall take effect and be in force from and after July 1, 2026.

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